Full Emergency Rooms Are Feeling the Effects of the Flu

By GEORGINA GUSTIN

Published: January 18, 2004

THE influenza virus that has killed dozens of children and sickened thousands of people around the country has tested Connecticut's already strained hospitals, jamming emergency rooms, filling every inpatient bed and breaking hospital census records around the state.

Hospitals began reporting higher than normal inpatient populations beginning in late November after the flu first struck. But over the holidays, and particularly during the weekend following the New Year, hospitals started feeling an added crush of patients. Hospital staff were forced to juggle people from bed to bed and emergency rooms were logjammed as people streamed in for care.

''We're packed right now, just like everyone else in Connecticut,'' said Dr. Victor Morris, assistant chief of staff at the Yale-New Haven Hospital, last week. ''We're moving people around who are the least sick to get more in the I.C.U.''

At many of the state's 33 acute-care hospitals, intensive or critical care units were completely full, surgeries were canceled and patients were being asked to spend the night in emergency room beds.

''Our volumes are unprecedented,'' said Dr. Michael Carius, chairman of the Department of Emergency Medicine at the Norwalk Hospital, where all the inpatient beds and the I.C.U. have been full. ''For the month of December our population was up 10 percent over last year, and I would attribute that to influenza, and the complications of influenza: pneumonia and dehydration. We're literally filling every bed we have on an ongoing basis.''

This latest spike in the state's inpatient population has once again underscored a statewide and national crisis of hospital overcrowding, according to Ken Roberts of the Connecticut Hospital Association. ''The capacity that was fine a few years ago is starting to be strained particularly at times like this when we have a high demand for services,'' Mr. Roberts said. ''There's the problem of physical capacity. But there's the staffing capacity, too. There might be beds in a hospital, but no one there to staff them.''

Any bump in patients stretches hospital resources, testing the thin financial margins on which they operate. ''If you're running very close to the margin, there's no ability to staff above what the average demand might be,'' Mr. Roberts added. ''Hospitals have to do the best they can within the financial realities of today's health care environment.''

Doctors and public health experts said the holidays are typically high-volume periods for hospitals, but this year has been exceptional, a fact doctors blamed on this year's nasty flu outbreak. And while many of the patients filling beds in the state's hospitals haven't been tested for the flu, and may in fact not have the flu at all, doctors believe their symptoms are flu-related.

''This began the weekend before Thanksgiving and that's when the first flu cases hit,'' said Kelly Anthony, a spokesman for the Lawrence and Memorial Hospital in New London, where seven to 10 people have been spending the night in the emergency room because of the high inpatient population. ''Now we're seeing a spike in respiratory illness, particularly among the elderly, and we believe that many of the patients with chronic medical conditions are being impacted by the flu. It has triggered a lot of these illnesses.''

The same holds true for hospitals around the state.

''This is really tied to respiratory illnesses, like pneumonia, which may have been the flu to begin with and got worse,'' said John Cappiello, a spokesman for Bridgeport Hospital, which has seen an inpatient increase of 20 percent over the past several weeks.

So far this year, about 3,000 people in the state have tested positive for influenza. But health experts stress this number is only a suggestion of how many people in the state actually have the flu.

The flu has become a catchall term for anyone suffering from aches, pains, chills and sniffles, and is often confused with the common cold. But while the flu and the cold are both respiratory illnesses, they are caused by different viruses, and the symptoms of the flu, which include high fever, headache, fatigue, dry cough, sore throat, runny nose and body aches, are often more severe.

The flu typically circulates from late fall to spring, making the early onset of this year's epidemic all the more striking. So far, as of Jan. 8, 93 children have died because of the flu and it has sickened thousands around the country.

The outbreak has caused some people to overreact, sending more people to the emergency room and to hospitals for treatment.

''Hospitals are attributing some of the capacity to the fears about the flu,'' said Mr. Roberts of the hospital association. ''People are bypassing their family practitioners and going right to the E.R.''

The Centers for Disease Control and Prevention has urged people to look for ''emergency warning signs'' that require immediate attention. In children, those include a high or prolonged fever, fast or troubled breathing, bluish skin color, lethargy or seizures. In adults, they include high fever, difficulty breathing, confusion, pressure in the chest and severe or persistent vomiting.